LSU First Wellness
LSU First is committed to helping our members achieve their best health. Routine preventive care, such as a primary care provider (PCP) visit, biometric screening/routine lab work, and other age-appropriate screenings often detect health issues early, when they are easier to treat. Preventive services are covered at 100% with a First Choice or In-Network provider.
2024 LSU First Wellness Credit
LSU First is expanding the wellness credit for the 2024 Plan Year to include covered spouses! Employees with Employee + Spouse or Family coverage will be eligible for an additional $10/month premium credit.
To qualify or to continue the $25/month premium wellness credit ($35/month for those with a covered spouse) for the 2024 plan year, the following requirements must be met:
- Continue to be enrolled in LSU First for the 2023 and 2024 plan years.
- Employee and covered spouse (if applicable) must have a preventive visit with a Primary Care Physician (PCP) that includes biometric screening (height, weight, BMI, & blood pressure) and preventive lab work that includes a basic metabolic panel between November 1, 2022 - October 31, 2023.
- Active participation in care coordination, if identified as a candidate by HighCare, is required to maintain the wellness credit. Plan members will be contacted directly by the care coordination team through HighCare.
- Both the employee and spouse must meet the requirements to qualify for the credit. If either the employee or covered spouse fails to meet the requirements to qualify for the wellness credit, no premium credit will be awarded.
LSU First participants who do not complete the criteria for a Wellness Credit within the designated timeframe will not be eligible for the wellness credit for the 2024 plan year.
LSU First reserves the right to alter requirements of the wellness credit each plan year. The wellness credit does not apply to covered child(ren) or to the LSU First Medicare Retiree Plan.
2023 LSU First Wellness Credit
To qualify or to continue the $25/month premium wellness credit for the 2023 plan year, the following requirements must be met:
- Continue to be enrolled in LSU First for the 2022 and 2023 plan years.
- Have a preventive visit with a Primary Care Physician (PCP) that includes biometric screening (height, weight, BMI, & blood pressure) and preventive lab work that includes a basic metabolic panel between November 1, 2021 - October 31, 2022.
- Active participation in care coordination, if identified as a candidate by HighCare, is required to maintain the wellness credit for the 2022 and 2023 plan years. Plan members will be contacted directly by the care coordination team through HighCare.
- LSU First participants who do not complete the criteria for a Wellness Credit within the designated timeframe will not be eligible for the wellness credit for the 2023 plan year. LSU First reserves the right to alter requirements of the wellness credit eligibility each plan year. The wellness credit does not apply to covered dependents or to the LSU First Medicare Retiree Plan.
The 2023 Wellness Credit for LSU First participants who met the requirements will be reflected beginning on December paychecks as premiums are paid a month in advance. Please review your December deductions to confirm the credit is reflected. If you believe you have met the requirements but do not see it applied, please contact WebTPA at 855-346-5781 by January 31, 2023. Appeals submitted after January 31, 2023 will be denied.
Frequently Asked Questions
To qualify for the $25/month premium credit, employees or retirees must:
- Be enrolled in LSU First for the 2022 Plan Year,
- Have a preventive visit with a Primary Care Physician (PCP), including biometric screening/routine lab work, between November 1, 2020 - October 31, 2021,
- Enroll and participate in care coordination, if identified as an eligible participant, in the 2022 plan year.
The credit is available to employees and retirees for the 2022 Plan Year. Spouses and/or dependents are not eligible for the premium credit, but it is highly encouraged that all covered members receive an annual preventive visit and lab work.
Establishing a relationship with a Primary Care Physician (PCP) is crucial in providing preventive care and identifying and treating common medical conditions. PCPs have expertise in managing multiple treatments, medications, and the interactions between them. They can address the entire person, considering their values, beliefs, and preferences. They can also provide references to specialists, when needed.
- Family Practice
- General Practice
- Internal Medicine/Internist
The Affordable Care Act (ACA) requires that health insurance plans cover certain preventive services, including annual exams, immunizations, and screenings, from an In-Network provider without any cost sharing. This means that the visit is covered at 100% if received through the First Choice, Verity, or Aetna ASA Networks.
See the following websites for more details:
- HealthCare.gov - Preventive Care Benefits
- U.S. Preventive Services Taskforce - A & B Recommendations
NOTE: The Preventive Care services identified through the above links are recommended services. It is up to your provider to determine which services are best for you.
The $25 monthly wellness credit will be applied towards your monthly LSU First premium during the 2022 Plan Year.
No paperwork or form is necessary. The wellness exam and lab work will be identified through the claim(s) that your provider submits to WebTPA. If you do not see the wellness credit applied to your paycheck, please contact WebTPA no later than February 15, 2022 to inquire about your eligibility.
To confirm you have met the wellness exam and lab work requirement, please contact WebTPA by phone at 855-346-5781 or email at firstname.lastname@example.org. You may also check your paystub to see if the credit has been applied, either as a separate line item or as a credit to your total monthly deduction. You can find a list of the 2022 LSU Health Plan premiums on the LSU First homepage sidebar.
The results of your preventive visit and biometric screening are personal and confidential and will not be shared with your employer.
A typical screening usually consists of height, weight, BMI measurements, and blood pressure as well as blood work to test for cholesterol and blood sugar. The lab work may vary by individual based on gender, age, and family history. Note that there may be some out-of-pocket costs if seeking care outside of the First Choice network.
If it is medically inadvisable to meet the 2nd requirement due to reasons such as illness, pregnancy or recent surgery, you may be able to qualify under alternative requirements, such as working with your Primary Care Physician (PCP) to develop a plan to improve your health. Please contact WebTPA for an exemption form that includes signature by your PCP for consideration of the wellness credit outside of #2 above. Requirements 1 and 3 must still be met to qualify.
Care Coordination, provided by HighCare Health, provides personalized assistance to help eliminate barriers to health and well-being. The team works directly with members and their Primary Care Providers (PCPs) to identify, understand, and take control of health risks and chronic diseases. For more information on this free service, please see the Care Coordination flyer or contact them directly at 844-218-8740.
HighCare Health will reach out directly to those who are identified as eligible participant via phone, email, and mail. Please verify that your Human Resource Management office and WebTPA have your correct contact information. Failure to participate in Care Coordination for those specifically identified will be at risk of losing the wellness credit mid-year.